FAP Application Form
We are committed to providing exceptional laboratory services regardless of your ability to pay. However, we are also obligated to remain compliant with governmental and insurance policy guidelines.
Our billing department can offer solutions for uninsured or underinsured patients based on individual circumstances. Patients may qualify for prompt pay discounts, payment plans or financial assistance to reduce or eliminate a patient's out of pocket responsibility.
For those patients who do not meet the national guidelines and/or their insurance guidelines we can offer a self pay rate of $250.00. This rate is not eligible for financial assistance or any other discounts. It is also not available for patients with Medicare/Medicaid per governmental guidelines.
If you have received an explanation of benefits from your insurance or a bill and have questions, please contact our dedicated customer service representatives who are here to discuss your options in detail.
Phone: 888-599-5227 – Billing option
Email: fap.billing@siparadigm.com
Financial Assistance for Underinsured Patients
siParadigm offers financial assistance to reduce out-of-pocket costs for qualified underinsured patients in the U.S., depending on their household income level. Examples of patients who are considered underinsured include:
To be eligible, patients must have insurance and meet the low income requirements (household incomes up to 400 percent of the Federal poverty level).
Financial Assistance for Uninsured Patients
siParadigm offers financial assistance to reduce out-of-pocket costs for qualified patients in the U.S. who do not have medical health insurance, depending on their household income level. To be eligible, patients must meet the low income requirements (household incomes up to 400 percent of the Federal poverty level).
A separate Application Form is required. The financial criteria below are for informational purposes only. This document need not be included with your application submission.